Task force studies ways to improve health care

Published: Saturday, December 1, 2012 at 06:35 PM.

“You don’t have to stop your regular life or stop having fun,” she said. “You can deal with it; if you can manage it, you’re OK.”

Type 2 diabetes occurs when fat, liver and muscle cells do not respond correctly to insulin; the condition is referred to as insulin resistance. Chitwood said that often, Type 2 is reversible.

“There’s so much attention once you’re diagnosed, on how to manage it. … We don’t think there’s enough being done to prevent diabetes in the first [place] and it is extremely preventable,” Chitwood said. “You can stop it and in some cases you can reverse it with behavior modifications.”

He said one of the focuses for the task force on diabesity is metabolic syndrome, a group of risk factors that occur together and increase the risk for coronary artery disease, stroke and Type 2 diabetes.

Chitwood said excess weight around the waist is one of the signs of metabolic syndrome and Type 2 diabetes, so the task force wants to stress the importance of exercise. For many overweight people, losing 10 percent of their body weight can make a drastic difference, he said.

The task force is working on a mass public screening for diabetes they hope to do in late February or early March.

PANAMA CITY — Saquilla Brown is a 25-year-old mother who is slender and active. She’s also diabetic.

Katrina Northcutt and her daughter had chronic conditions, but needed help navigating the application process for insurance.

Donna Schmitt quit smoking after 40 years and found out she has an irreversible health problem.

The situations these three women found themselves in are what a task force says are the three major critical health care needs in Bay County.

Comprised of health care and education officials and many members of the community, the Bay County Health Task Force facilitated a health needs assessment and the result is a three-section Community Health Improvement Plan (CHIP).

CHIP covers obesity and diabetes (diabesity), access to health care and healthy lifestyles education. Although the sections cover different issues, Randy Chitwood, coordinator for the RN-BSN program at Gulf Coast State College and an early member of the health task force, said each section also focuses on education.

“With diabesity, it has to be there to educate the public about risk factors, metabolic syndrome and prevention,” Chitwood said. “With access to health care … it’s as much marketing as education, and the primary goal of the healthy lifestyles committee is increasing awareness of lifestyle choices as they relate to poor health. An educated public can make wiser choices … and will be healthier.

Diabesity

Saquilla Brown’s diagnosis of Type 1 diabetes, when the body produces little or no insulin, came during a checkup after her thyroid removal surgery earlier this year. She said the biggest myth about diabetes is giving up certain foods.

“I can have anything I want. … It’s the amount,” she said. “I can have cake and ice cream; I just can’t have as much.”

Brown has a diabetes educator whom she can turn to with any questions.

“It’s just a learning process; every day I learn something new,” Brown said. “It could be on the Internet, on TV. I attended the diabetes classes at the health department; I can pick up a pamphlet at the doctor’s office. There’s so much; one book can’t give me all of the information.”

Brown is able to regulate her blood sugar enough that her need for insulin injections has been reduced, but her condition is not reversible.

“You don’t have to stop your regular life or stop having fun,” she said. “You can deal with it; if you can manage it, you’re OK.”

Type 2 diabetes occurs when fat, liver and muscle cells do not respond correctly to insulin; the condition is referred to as insulin resistance. Chitwood said that often, Type 2 is reversible.

“There’s so much attention once you’re diagnosed, on how to manage it. … We don’t think there’s enough being done to prevent diabetes in the first [place] and it is extremely preventable,” Chitwood said. “You can stop it and in some cases you can reverse it with behavior modifications.”

He said one of the focuses for the task force on diabesity is metabolic syndrome, a group of risk factors that occur together and increase the risk for coronary artery disease, stroke and Type 2 diabetes.

Chitwood said excess weight around the waist is one of the signs of metabolic syndrome and Type 2 diabetes, so the task force wants to stress the importance of exercise. For many overweight people, losing 10 percent of their body weight can make a drastic difference, he said.

The task force is working on a mass public screening for diabetes they hope to do in late February or early March.

Health care access

Getting medical coverage for children is something many people handle quickly — simply by adding options on their coverage. For others, it takes persistence and multiple boxes of paperwork. Katrina Northcutt has several of those boxes in her garage, although she hasn’t needed to show anyone the paperwork in years.

Northcutt and her daughter Leila both needed health coverage for chronic conditions, and trying to qualify for Medicaid was not a simple process.

“There were things you had to call and update on with the state, but every time you call, it was busy and it would say there were too many people in the queue already and it would hang up on you,” Northcutt said. “It would take calling 15 times a day for three days to actually get somebody on the phone, and that’s ridiculous. Just access to health care, period, where you can afford to go to the doctor is a very long, frustrating process.”

The paperwork requirements were strenuous as well. Northcutt said if there was one small slip-up, you had to start the process all over again.

“The hardest part was probably sending in all of the paycheck stubs,” Northcutt said. “They want every paycheck stub, and even I would have to go ask my employer sometimes to print out one or two I was missing and I’m educated and organized. There are people who don’t keep this kind of stuff.”

Northcutt went back to school, switched careers and is now a registered nurse. She said having stable coverage and having choices about their health care has made a world of difference.

“I’m not on blood pressure medicine or high cholesterol medicine, acid reflux medication anymore,” Northcutt said. “I got the better care I needed. It’s nice to be able to go in and see someone that listens instead of just treating the acute things going on.”

Leila, who had been in and out of hospitals and doctors’ offices, hasn’t been a hospital patient in about two years.

Jon Cupp, chair of the Access to Health Care action team, said they want to take that lack of knowledge out of the equation.

“For individuals in crisis, it’s disheartening to go somewhere, find out you’re not eligible for their services or you have the wrong paperwork with you,” Cupp said. “We want to eliminate that. There can be a system of providers working together so people can be better shoppers of health care and better prepared.”

This action team has three goals: one, establish a single point of eligibility data system; two, implement a “211” telephone system; and three, create an advocacy campaign to keep the community educated on what’s currently available.

The data system would streamline access for individuals, keeping information about special care needs in one place. Cupp said the 211 system is much like the current 411 system, just focused on information related to health care, food banks and housing. He said they aren’t trying to create a brand new 211 system; they are meeting with other people in the state that already use this type of system to find the best option for Bay County.

“We want an ongoing advocacy campaign looking at advocating what’s available and make it so people can get to the information,” Cupp said. “Also, make it possible for people to have a point of access for eligibility and paperwork; that’s the campaign we’ve developed that we want to grow over time. It’s going to have to be dynamic and grow with the community for what they need.”

Healthy lifestyles

Donna Schmitt has always been active, walking or bike riding almost every day and eating mostly healthy foods. A detriment to her health was smoking. So, she quit. During a hospital visit in October, she got bad news.

“That was a rude awakening or reality check for me because you would assume that if you’ve always eaten healthy, your weight is in alignment and you have no health issues. I don’t have high blood pressure or cholesterol or any of that, but I was in there (hospital) and due to those 40 years of smoking, I had flattened my diaphragm,” Schmitt said. “That’s irreparable damage … and I have an irregular heartbeat. They’re still doing tests on me.”

She had decided to quit for several reasons and enjoys the extra free time now that she quit. One of the resources she used to help her quit was smoking cessation classes through the Health Department, and Schmitt said it made a huge difference to have the support system of the other people in the class and their instructor, Lisa Rahn.

“It’s probably the best thing I’ve done. I feel a lot better,” Schmitt said. “My skin looks better, I have more energy; there’s been a lot of positives. … I’d recommend those classes to anyone who wants to quit.”

She’s taken her new perspective and wants to help others avoid the situation she’s in.

“I’ve joined a committee for teenagers against cigarettes,” Schmitt said. “I figure if I could start with the young people and keep them from even getting on the cigarettes, that would help. Maybe if I can take my experience and share, maybe I can help other people not do this, at least the young people.”

She also joined the healthy lifestyles committee, giving her testimony to others.

“I’d like to give back and maybe somebody can benefit a lot sooner than I did,” Schmitt said.

Rahn, the Healthy Bay coordinator for the Bay County Health Department and a part of the CHIP task force, said their plan is twofold; one section focuses on increasing awareness of healthy lifestyles and resources for youth under age 12, and the other section will do the same for adults.

“We’re going to have a website with links on healthy eating, exercise, bullying and personal hygiene,” Rahn said. “Mental health is part of overall health. … Cyberbullying has become such big issue, we want to raise awareness in the youth, those who teach them, their parents and people who interact with them in the community to recognize the signs and how to put a stop to it.”

She said it’s a combination of movement and food.

“We also want to raise awareness of the free or lost cost exercise opportunities in Bay County,” Rahn said. “We have discussed approaching supermarkets and convenience stores in our community about offering healthier choices. We want to highlight the fact that even in fast-food restaurants, there are healthier choices that can be made.”

She said they also are looking at several projects to get involved with over the next year to provide information and support to organizations providing opportunities for healthier choices.

“The healthy lifestyle education committee overlaps a lot with other areas in CHIP,” Rahn said. “It goes hand in hand with diabesity and adopting healthier lifestyles. There is not a clean demarcation between these groups. If you don’t have access to health care that you need, it’s hard to live a healthy life.”

Want to help?

Anyone interested in getting involved in the task force can contact Lisa Rahn for healthy lifestyles and access to health care at Lisa_Rahn@doh.state.fl.us or call 850-872-4455, ext. 1344; and Jo Colville for the diabesity section at JColville@baymedical.org.